Gov. Perry Rejects Medicaid Expansion  

On July 9, Gov. Rick Perry announced that Texas will not expand Medicaid under the Affordable Care Act (ACA), nor will Texas move to create a state health insurance exchange.  This decision means turning down federal funding of health coverage for up to 2 million uninsured Texans, and represents another blow to healthcare access for low-income Texans, including access to preventive care and birth control.

Coverage under the ACA Medicaid expansion, if accepted, would begin in 2014, and expand the program to adults at or below 133% of the Federal Poverty Level (about $30,600 annual income for a family of 4). Under the ACA, the federal government would pay 100% of the costs for the first 3 years, and at least 90% after that.  The Center for Public Policy Priorities estimates that accepting the Medicaid expansion would bring Texas $76.3 billion in federal matching funds by 2019, with Texas's costs increasing by only $5.8 billion.  

Healthy Futures of Texas president Dr. Janet Realini was saddened by the decision.  "One in 4 Texans is uninsured, the highest percentage of any state.  Among women of reproductive age, it is even higher: 1 in 3.  We know that uninsured people are 40% more likely to die.  It is simply unconscionable to leave millions of Texans without coverage.  Members and friends of the Healthy Futures Alliance coalition want to see as many of our families as possible covered, so they can access preventive care and get the care they need when they are sick or injured."

On June 28, the U.S. Supreme Court upheld the constitutionality of the ACA, also known as "Obamacare", but ruled that the states could opt out of the ACA's expansion of Medicaid without penalty. Several other Republican governors have indicated they would not accept the Medicaid expansion.

Medicaid is the federal-state healthcare program that covers the poor and disabled, primarily low-income children, pregnant women, and elderly in long-term care.  Texas has historically covered the minimum number of people, offered minimum services, and paid such low rates that only a minority of physicians accepts Medicaid patients.  The ACA offers a way for Texas to improve and expand Medicaid with federal funding and a very low cost to the state.